Question

A 26-year-old woman presents to the clinic concerned about continuing her psychotropic medication after finding out that she is pregnant. She has been taking antidepressants for her severe depression for 6 years. After a great deal of trial and error, her mood stabilized last year by taking both escitalopram 25mg and imipramine 75mg. She is 6 weeks pregnant but found out about her pregnancy 2 days ago. How should this patient be managed?

A. Switch to paroxetine
B. Lower dosage of imipramine
C. Completely stop all medication
D. Taper off imipramine and decrease dosage of escitalopram
E. Switch to nortriptyline

Answer 1

A 26-year-old woman, who is 6 weeks pregnant, is concerned about continuing her psychotropic medication. The best course of action for her would be to taper off imipramine and decrease the dosage of escitalopram under the guidance of her healthcare provider.

Step-by-step explanation:

In this case, the patient presents with severe depression and is currently taking both escitalopram and imipramine. Since she has recently found out about her pregnancy, it is important to consider the risks and benefits of continuing the medication. While stopping all medication may not be advisable as it could potentially worsen her depression, it is also not recommended to switch to paroxetine or nortriptyline due to their potential risks during pregnancy. The best course of action would be to taper off imipramine and decrease the dosage of escitalopram under the guidance of her healthcare provider.